运动神经元病患者大脑结构异常评估:基于多模态成像  

The Assessment of Brain Structure Changes in Motor Neuron Disease:Based on Multimodal Imaging

作　　者：刘园[1] 段莉琴 范文亮[1] 余建明[1] 雷子乔[1] LIU Yuan;DUAN Liqin;FAN Wenliang(Department of Neuroradiology,Union Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei Province 430022,P.R.China)

机构地区：[1]华中科技大学同济医学院附属协和医院,分子影像湖北省重点实验室,武汉430022 [2]浙江省中医药大学附属第一医院神经内科,310006

出　　处：《临床放射学杂志》2020年第1期36-41,共6页Journal of Clinical Radiology

摘　　要：目的探究性利用多模态影像技术评估14例运动神经元病(MND)患者脑部灰白质结构改变,分析疾病表征及脑内异常的相关性。方法14例临床诊断考虑为MND患者作为实验组,认知功能评分正常,14例年龄、性别和左右利手匹配的无神经系统疾病的志愿者为对照组,行常规磁共振扫描以及T13D和DTI扫描。应用Freesurfer软件对T13D数据进行分析,组间比较全脑皮层厚度差异。应用基于纤维束示踪的空间统计方法(TBSS)和基于白质模板分割法分析DTI数据,比较全脑白质结构差异。显著差异白质结构特征值与临床指标作相关性分析。结果与对照组相比,Freesurfer结果显示MND患者右侧颞上回和左侧额中回下部局部局限性皮层厚度减低(P<0.05,非FDR校正)。TBSS结果表明胼胝体至运动皮层区域皮质脊髓束FA值和F1值呈显著性降低(P<0.05,FEW校正),而相应区域F2、L1、MD等值未见明显差异,特别是左侧上放射冠白质纤维,其FA值显著性降低(P=0.007),并与ALSFRs评分正相关(r^2=0.723,P=0.004)。结论无明显认知障碍MND患者主要表现为轻微灰质结构改变,白质结构特别是胼胝体至运动皮层的皮质脊髓束纤维结构完整性损伤,运动功能皮层信息上下传导受阻。上放射冠FA值与疾病严重程度相关,未来可用于监测疾病严重程度和发展进程。Objective Motor Neuron Disease mainly manifests with loss of motor function,while cognitive ability was not significantly reduced.Multimodal imaging techniques were used to assess the changes in gray matter and white matter structure in 14 patients with motor neuron disease,and to analyze the correlation between disease characterization and abnormalities in the brain.Methods Fourteen patients with clinical diagnosis considered as motor neuron disease were included.Fourteen volunteers with no neurological diseases and matched with age,sex and handedness were used as control group.The scan protocol contained the high resolution 3 D T1 and DTI data.3 D T1 data was analyzed using Freesurfer software to compare the differences of cortical thickness in the whole brain between groups.The Tract-based spatial statistical method(TBSS)and white matter template-based segmentation methods were used to analyze DTI data,and the differences in white matter structure were compared.The correlation acquired between gray matter and white matter structure characteristic values and clinical indicators.Results Compared with the control group,Freesurfer method showed that the cortical thickness in right superior temporal and left middle frontal gyrus was decreased in patients with MND.The TBSS indicated that the FA and F1 showed a wide area reduction in the corticospinal tract between the corpus callosum to the motor cortex a wide area reduction,while there were no significant differences in the corresponding areas for F2,L1,MD.As for Template-based segmentation methods,FA value of the left superior corona radiata was significantly reduced and positively correlated with the ALSFRs score.Conclusion Patients with motor neuron disease without obvious cognitive impairment are mainly characterized by mildly gray matter changes and widely white matter dysfunction,especially the structural integrity impairment of the corticospinal tract fibers,following with the block of up-down linked information transfer from motor cortex to corpus callosum.

关 键 词：运动神经元病 多模态成像 纤维束示踪的空间统计方法 FREESURFER 认知障碍 

分 类 号：R445.2[医药卫生—影像医学与核医学] R744.8[医药卫生—诊断学]